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Gerd Holmstrom, Ann Hellström, Peter Jakobsson, Pia Lundgren, Kristina Tornqvist, Agneta Wallin; Evaluation of new guidelines for ROP screening in Sweden with the help of a national quality register - SWEDROP. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5908.
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© ARVO (1962-2015); The Authors (2016-present)
Recently, inclusion criteria for retinopathy of prematurity (ROP) screening in Sweden was lowered to < 31 weeks gestational age (GA) and start of screening was postponed until postmenstrual age (PMA) 31 weeks in infants with a GA less than 27 w. The present study aims to investigate whether these new guidelines are applicable in a new national cohort of prematurely born infants.
Data on various aspects of screening for ROP in infants with a GA < 32 w GA and born 2010 to 2011, were extracted from SWEDROP, a Swedish quality register for ROP. These data were compared with a previous cohort of infants born in Sweden 2008 to 2009. Comparison with a national perinatal quality register (SNQ) was also performed.
During 2010 to 2011, 1744 infants were screened for ROP, giving a national coverage of 95.7% (1744/1822) when compared with data from SNQ. The mean GA was 28.4 w (22 - 31) and the mean birth weight was 1239 g (382 - 2615). Screening was started at a mean postnatal age (PNA) of 5.4 weeks (0.4-13.3) and a mean PMA of 33.8 w (24.9 - 50.1) and the mean number of examinations was 5.4 per infant (1-38). Mild ROP was found in 15.4 % and severe ROP in 8.7 %. Treatment was performed in 4.2 % (73/1744) of the infants, but in none with a GA of 30 weeks or more. Nine infants were treated with Anti-VEGF in at least one of their eyes. Mean PNA and PMA at discovery of ROP 3 were 11.6 w (5.1 - 24.6) and 36.6 w (31.1 - 52.6), respectively. The first treatment was performed at a mean PNA and PMA of 12.7 w (7.7 - 25.4) and 37.4 w (32.1 - 51.4), respectively. There was a significant correlation between PMA at first treatment and GA at birth (p=0.01).
New guidelines for ROP screening need to be continuously evaluated. With the help of SWEDROP, a national register for ROP, analysis of a new cohort of infants born 2010 to 2011 reveals that recently introduced new guidelines for ROP screening in Sweden remain applicable. Further, the incidence of ROP, the frequency of treatment, the timing and frequency of examinations, the timing of treatment, and the national coverage of ROP screening remained almost identical to those of a previous cohort of infants born 2008 to 2009.
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